Hypertension - Breaking the Silence

It wasn’t until I was firmly entrenched in my medical schooling that I first heard the whispers of ‘the Silent Killer’. Silent and lethal? That caught my attention. Prior to this, my only understanding of something silent and deadly was found within the confines of the family car on long road trips.

But this thing I speak of, first leaned of in my formal schooling, is something more serious. More sinister. On occasion it can take our life quickly, but most of the time it is done slowly. Over long periods of time. And most of the time without us ever even knowing about it.

I am referring, as many of you I’m sure are aware, to ‘hypertension’. The medical term for the abnormal elevation of our blood pressure. That is, the pressure of the blood running through our arteries supplied by our heart.

If our body were a car, the brain might be a silicon valley microchip governing much of its movement, but the heart would be the engine. Only instead of making a car go, the heart is propelling a human body. It’s job is pumping fuel through lines throughout our body. Not a cell missed. It’s an important job. Equally important are all those fuel lines, called arteries. We all know if pressure is running too high through a fuel line there could be trouble. A line can be damaged by the high pressure or perhaps even burst. It can also have bad effects on the engine. Strain on the heart. Equally bad news for our arteries.

It is a fact too, that the natural evolution for the pressure in our arteries is to go up as those arteries age. As our blood vessels age they become less compliant. Stiffer. Harder. Pressure rises accordingly.

But here’s the great news. We can do something about it. And not just through diet and exercise, though the importance of those two variable can’t be overstated. We can all learn to personally measure, and periodically monitor, our own blood pressure, as the ease of doing so both technologically and fiscally has now made it not only a reasonable goal for all of us to have, but in truth a no-brainer from a sensibility standpoint. And just like you check the pressure on the tires of your car regularly if you know what’s good for you, we should all be checking the pressure in our our arteries on a routine basis. Not only as a tool for both the screening of our body for illness or disease, but as a barometer of the status of our engine. Our heart.

According to the American Heart Association, hypertension affects nearly 78 million Americans and its prevalence is increasing. It is a major contributor to diseases of the heart, the kidneys, and the brain, and its effective management is of critical importance both on an individual level and from a public health standpoint. Like many chronic diseases, self-management is particularly important.

So what is too high? High blood pressure, or hypertension, is defined as an elevation in pressure above 140/90 on two separate occasions. The top number, called the systolic pressure, is the pressure in our arteries as the heart contracts or beats. The lower number, termed diastolic pressure, is the pressure when the heart is relaxing between beats.

When you think about it, self-tracking of home blood pressure seems to be a task that should be particularly amenable to the health care consumers of today. The availability and evolution of mobile health tools like smartphone or tablet applications is redefining how we look at and and manage both our personal health and that within communities. Mobile health, with the evolution of our culture’s technology, is still in it’s infancy, but it is growing at a rapid rate. Just as there are apps for our phones now to help us track calories or assist in losing weight, there are apps and tools becoming available to address things like the tracking of your blood pressure.

Aside from allowing for the entry of blood pressure or blood sugar readings, of exercises performed, or calories consumed, there are even now on the market blood pressure cuffs that plug directly into an iphone or tablet. But for those of us that are perhaps not invested to that technological degree, there are far simpler options available for as little as 30 dollars at our local pharmacy. Many pharmacies also have machines in their lobby, available for any of us with a pen and paper.

It is pertinent to point out the importance of confirming that a chosen BP cuff is accurate. Though all of these machines are generally calibrated, it is wise to check its calibration against a manual reading in your doctor’s office. The size of the cuff used and the size of the arm being measured are important variables as well, though most commercial cuffs will fit the needs of the majority of people.

An additional important aspect of blood pressure assessment, both in clinic and at home, is use of proper technique. Technique for the machine has been simplified to the point of wrapping a cuff around your arm or wrist and pressing a button. But equally important is technique of when it should be checked.You generally want to be measuring blood pressure after a period of rest of 5 minutes or more. If you have questions about your monitor selection or the technique in using it, speak to your doctor.

Silent no more. The cats out of the bad. Our personal awareness and engagement can lead to a better understanding of important health markers, such as our blood pressure, and the familiarity gained will allow for better decision making and guidance both for us, the primary custodians of our care, as well as assisting our physician’s who help to champion our health and well being through the entirety of our lives.